Provider Demographics
NPI:1780376640
Name:PITTS, ANGELA (PA-C)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:PITTS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3195 SMYRNA CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:CULLEOKA
Mailing Address - State:TN
Mailing Address - Zip Code:38451-2616
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1830 HERITAGE PARK PLZ
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37129-1575
Practice Address - Country:US
Practice Address - Phone:615-900-2621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2024-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN5444363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant